Needle Fingers. Melee Weapon Attack: +10 to hit, reach 10 ft., one target. Hit: 21 (3d10 + 5) piercing damage. In addition, the target must make a DC 19 Constitution saving throw; if it fails, the cambium can either inflict Ability Damage or Imbalance Humors. A target makes this saving throw just once per turn, even if struck by more than one needle fingers attack.

Ability Damage (3/Day). When the target of the cambium’s needle fingers fails its Constitution saving throw, the cambium can choose to inflict 1d4 damage to one of the target’s ability scores. A greater restoration or greater magic is required to restore this damage.

Imbalance Humors (3/Day). When the target of the cambium’s needle fingers fails its Constitution saving throw, apply one of the following effects: Sanguine Flux: The target cannot be healed-naturally or magically-until after their next long rest.

Choleric Flux: The target becomes confused (as the spell) for 3d6 rounds. The target can repeat the saving throw at the end of each of its turns to shrug off the flux before the duration ends.

Melancholic Flux: The target is incapacitated for 1d4 rounds and slowed (as the spell) for 3d6 rounds. The target can repeat the saving throw at the end of each of its turns to shrug off the flux before the duration ends.

Unfolding impossibly from beneath voluminous robes, this creature’s pockmarked, spindly arms end in clusters of narrow spikes. Its long, hollow, needle-like fingers and its many-jointed arms move with surprising speed and strength for such an emaciated creature.

Hunched and Robed. The cambium skulks through mortal society, hunched and contorted, concealing its nine-foot height and its supernumerary arms.

Devours Bodily Humors. The source of a cambium’s interest lies in every mortal body: the four humors, which it drains in precise amounts, sometimes to fix its own imbalances, sometimes to concoct serums meant for sale in hellish markets. Its victims are left in a desperate state, eager for a corrective fix and willing to obey the cambium’s every whim as servants and toadies.

Abandons Victims. After a sufficient crop has been harvested, the cambium abandons these addicts to die slowly from violent withdrawals, and allows the local population to lie fallow for a decade or so.